In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe

Mayer, Susanne; Berger, Michael; Konnopka, Alexander; Brodszky, Valentin; Evers, Silvia M. A. A.; Roijen, Leona Hakkaart-van; Gutiérrez-Colosía, Mencía R.; Salvador‐Carulla, Luis; Park, A‐La; Hollingworth, William; García-Pérez, Lidia; Simon, Judit; Group, On Behalf Of The Pecunia

doi:10.3390/ijerph19063500

Cited by 18 publications

(20 citation statements)

References 36 publications

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“…Therefore, even if a researcher needs data for some item that has not been introduced into the database so far, he or she can find it in the original source. The EU HCSCD also provide an useful input for standardized unit cost templates for a multi-sectoral service and resource use measurement instrument developed as part of PECUNIA project to ensure cross-country comparability and transferability [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Development of the European Healthcare and Social Cost Database (EU HCSCD) for use in economic evaluation of healthcare programs

Espín

Špacírová

Rovira

et al. 2022

BMC Health Serv Res

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Introduction Costs are one of the critical factors for the transferability of the results in health technology assessment and economic evaluation. The objective is to develop a cost database at the European level to facilitate cross-border cost comparisons in different settings and explains the factors that lead to differences in healthcare costs in different countries, taking into account the differences between health systems and other factors. Methodology The core of the database is compounded of three main categories (primary resources, composite goods and services, and complex processes and interventions) organized into 13 subcategories. A number of elements providing as detailed information of unit cost as possible were identified in order to mitigate the problem of comparability. Consortium partners validated both the database structure and selected costing items. Results Twenty-seven costing items included in the EU HCSCD resulted in 1450 unit costs when taking into account all item subtypes and countries. Cross-country differences in costs are driven by the type of resources included in the costing items (e.g., overhead costs in case of complex processes and interventions) or by the variety of existing brands and/or models and the type of unit value in most of the primary resources. Conclusion The EU HCSCD is the only public unit healthcare and social cost database at European level that gather data on unit costs and explains differences in costs across countries. Its maintenance and regular data updating will enable establishing specific systems for generating and recording information that will meet many of its current limitations.

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Section: Discussionmentioning

confidence: 99%

Development of the European Healthcare and Social Cost Database (EU HCSCD) for use in economic evaluation of healthcare programs

Espín

Špacírová

Rovira

et al. 2022

BMC Health Serv Res

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“…This process included three steps: (I) a systematic review to produce a preliminary listing of service terms based on scientific and grey literature; (II) an expert survey and a consecutive revision for the production of the final listing; (III) disambiguation of the terms included in the final listing adapting the previously tested method of Maciejewski et al (2002). Steps I and II are fully described elsewhere (Fischer et al, 2022;Mayer et al, 2022).They involved three working groups and two expert panels. Working group A included three experts in health economics from the University of Hamburg (PH, AK, CD) that led step I and participated in step II.…”

Section: Methodsmentioning

confidence: 99%

“…(2002). Steps I and II are fully described elsewhere (Fischer et al ., 2022; Mayer et al ., 2022). They involved three working groups and two expert panels.…”

Section: Methodsmentioning

confidence: 99%

“…This study was part of the PECUNIA project (ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions) conducted from 2018 to 2021. PECUNIA was aimed at developing standardised multi-sectoral, multi-national and multi-person RUM instruments, unit cost valuation templates, reference unit costs and outcome assessment tools to improve the methodology and comparability of economic evaluations in the European Union with a special focus on mental health (Mayer et al ., 2022 ). The PECUNIA consortium coordinated by the Medical University of Vienna consisted of ten partners for health economics and health systems research, located in six European countries (Austria, Germany, Hungary, Spain, The Netherlands and UK) (The PECUNIA group, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

“…( 2002 ). Steps I and II are fully described elsewhere (Fischer et al ., 2022 ; Mayer et al ., 2022 ).They involved three working groups and two expert panels. Working group A included three experts in health economics from the University of Hamburg (PH, AK, CD) that led step I and participated in step II.…”

Section: Methodsmentioning

confidence: 99%

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Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health

Gutiérrez-Colosía

Hinck

Simon

et al. 2022

Epidemiol Psychiatr Sci

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Aims Health services research (HSR) is affected by a widespread problem related to service terminology including non-commensurability (using different units of analysis for comparisons) and terminological unclarity due to ambiguity and vagueness of terms. The aim of this study was to identify the magnitude of the terminological bias in health and social services research and health economics by applying an international classification system. Methods This study, that was part of the PECUNIA project, followed an ontoterminology approach (disambiguation of technical and scientific terms using a taxonomy and a glossary of terms). A listing of 56 types of health and social services relevant for mental health was compiled from a systematic review of the literature and feedback provided by 29 experts in six European countries. The disambiguation of terms was performed using an ontology-based classification of services (Description and Evaluation of Services and DirectoriEs – DESDE), and its glossary of terms. The analysis focused on the commensurability and the clarity of definitions according to the reference classification system. Interrater reliability was analysed using κ. Results The disambiguation revealed that only 13 terms (23%) of the 56 services selected were accurate. Six terms (11%) were confusing as they did not correspond to services as defined in the reference classification system (non-commensurability bias), 27 (48%) did not include a clear definition of the target population for which the service was intended, and the definition of types of services was unclear in 59% of the terms: 15 were ambiguous and 11 vague. The κ analyses were significant for agreements in unit of analysis and assignment of DESDE codes and very high in definition of target population. Conclusions Service terminology is a source of systematic bias in health service research, and certainly in mental healthcare. The magnitude of the problem is substantial. This finding has major implications for the international comparability of resource use in health economics, quality and equality research. The approach presented in this paper contributes to minimise differentiation between services by taking into account key features such as target population, care setting, main activities and type and number of professionals among others. This approach also contributes to support financial incentives for effective health promotion and disease prevention. A detailed analysis of services in terms of cost measurement for economic evaluations reveals the necessity and usefulness of defining services using a coding system and taxonomical criteria rather than by ‘text-based descriptions’.

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A novel set of Austrian reference unit costs for comprehensive societal perspectives consistent with latest European costing methods for economic evaluations

Berger

Mayer

Simon

2022

Wien Klin Wochenschr

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SummaryDecision making in public health often happens against the background of scarce resources. The systematic use of economic evaluations can be a main enabler in the alignment of public health goals with budgetary constraints. However, the lack of standardized methodology in terms of costing method and perspective are a critical barrier to the implementation of economic evaluations and the international comparability of results. We present a novel set of 22 reference unit costs (RUCs) optimized for cross-sectoral economic evaluations in Austria suitable for international comparability calculated using the standardized PECUNIA RUC Template. The common framework for costing and reporting, as well as the easy availability of the RUCs will reduce the burden on researchers and policy makers in future economic evaluations. The higher quality, accuracy, transparency and availability of economic evidence for policy design will help to improve the efficiency of public health-relevant healthcare decisions and make it easier for policy makers to bring funding arrangements and decision making across multiple sectors in line with Health-in-All-Policies goals.

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In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe

Cited by 18 publications

References 36 publications

Development of the European Healthcare and Social Cost Database (EU HCSCD) for use in economic evaluation of healthcare programs

Development of the European Healthcare and Social Cost Database (EU HCSCD) for use in economic evaluation of healthcare programs

Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health

A novel set of Austrian reference unit costs for comprehensive societal perspectives consistent with latest European costing methods for economic evaluations

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